PREVAIL
Trial question
What is the effect of peer support in patients hospitalized for suicide risk?
Study design
Multi-center
Open label
RCT
Population
Characteristics of study participants
60.0% female
40.0% male
N = 455
455 patients (273 female, 182 male).
Inclusion criteria: adult patients hospitalized for suicide risk.
Key exclusion criteria: attending psychiatrist determination that a peer relationship would not be feasible or helpful due to unstable psychosis, cognitive disorder, or severe personality disorder; cognitive impairment according to the Mini-Cog screening test; receipt of peer specialist support for suicide prevention; planned discharge to another inpatient or residential facility; receipt of electroconvulsive therapy; homicidal ideation or violent behavior in the past 6 months.
Interventions
N=229 peer support (1-on-1 peer specialist support for 3 months focused on protective factors for preventing suicide [Peers for Valued Living]).
N=226 enhanced usual care (one caring message from the study team posthospital discharge).
Primary outcome
Any suicide attempt at 6 months
14.9%
17.2%
17.2 %
12.9 %
8.6 %
4.3 %
0.0 %
Peer
support
Enhanced usual
care
No significant
difference ↔
No significant difference in any suicide attempt at 6 months (14.9% vs. 17.2%; OR 1, 95% CI 0.91 to 1.09).
Secondary outcomes
No significant difference in mean Beck Scale for Suicidal Ideation at 6 months (4.9 points vs. 4.3 points; MD 0.81, 95% CI -0.57 to 2.19).
Significant increase in mean Hope Scale score at 3 months (33.4 points vs. 30.6 points; MD 2.8, 95% CI 0.27 to 5.33).
Safety outcomes
No significant difference in death and adverse events.
Conclusion
In adult patients hospitalized for suicide risk, peer support was not superior to enhanced usual care with respect to any suicide attempt at 6 months.
Reference
Paul N Pfeiffer, Kristen M Abraham, Adrienne Lapidos et al. Peer Support Intervention for Suicide Prevention Among High-Risk Adults in Michigan: A Randomized Clinical Trial. JAMA Netw Open. 2025 May 1;8(5):e2510808.
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